Children’s Perception of Parental Body Size and Its Association with Their Desire to Be Like the Parent

Background: Childhood obesity is a major and growing public health challenge worldwide. Although parental misperception of children’s weight is well documented, how children perceive their parents’ body size and whether parental body size is associated with children’s expressed desire to be like the parent have received little attention. We examined children’s perception of parental body size and whether parental BMI was associated with their expressed desire to be like the parent in a primary care sample. Methods: This single-center, cross-sectional study included 229 parent–child pairs consecutively recruited from a family medicine outpatient clinic in Türkiye between January and March 2026. Children aged 4–8 years rated the accompanying parent’s body size and reported whether they wanted to be like that parent, while parents independently rated their own body size. The BMI-based Body Size Guide was used for all figure selections, and the classification derived from objectively measured parental BMI served as the primary reference. Agreement was evaluated using Cohen’s kappa coefficients, associations were examined using multivariable logistic regression, and the children’s spontaneous explanations were examined using qualitative content analysis. Results: Parents showed moderate weighted agreement with the BMI-derived classification (weighted κ = 0.536, 95% CI: 0.456–0.612; exact agreement: 59.4%), whereas children showed fair weighted agreement (weighted κ = 0.315, 95% CI: 0.231–0.392; exact agreement: 42.8%). After adjustment for child age, child sex, child weight status, parent sex, and parent age, parental overweight (aOR = 0.353, 95% CI: 0.170–0.733) and parental obesity (aOR = 0.133, 95% CI: 0.057–0.307) were associated with lower odds of the child reporting a desire to be like the parent. After adjustment for child age, child sex, parent sex, and parent age, parental overweight (aOR = 2.818, 95% CI: 1.101–7.211) and parental obesity (aOR = 4.774, 95% CI: 1.816–12.546) were associated with higher odds of child overweight/obesity. Among the 53 children who provided an explanation, responses referred to body size, weight, health, appearance, affection, and identification with the parent, illustrating the broad interpretation of the question. Conclusions: Children aged 4–8 years were able to rate parental body size, although their agreement with the BMI-derived classification was limited. Children’s expressed desire to be like the parent varied according to parental BMI; however, this broad question may reflect emotional, relational, behavioural, and appearance-related considerations rather than bodily resemblance alone. The open-ended responses provide context by showing that only some children spontaneously referred to body size or weight. These findings support further research using developmentally validated and stigma-sensitive measures to clarify how young children perceive parental body size and interpret questions about identification with a parent.